PLAC: Planning Your Visit

To schedule an office appointment at our Fairfax Office, please call (703) 289-1410 during regular business hours.

A parent or guardian must be present at the visit.

You will need to bring to the first appointment:

• All current medications,
• Photographs of rash or symptoms if applicable,
• Results of prior testing (skin testing, blood testing, endoscopy, etc) if relevant to your visit with us.

Please bring these items to each appointment:

• The patient’s current health insurance card(s),
• Drug Prescription Card (if applicable),
• Proof of identification,
• Copay, if applicable.

New patients are registered in our system and important patient forms are completed prior to their first appointment.

You may bring these forms with you to your initial appointment:

• Registration Form English | Spanish
• Notice of Privacy Practices English | Spanish
• Consent to Treatment/Acknowledgement of Receipt of Notice of Privacy Practices for parent/guardian of a minor child English | Spanish
• Consent to Treatment/Acknowledgement of Receipt of Privacy Practices for adult patients English | Spanish
• Financial Responsibility Statement English | Spanish
• Medical Permission Form English | Spanish
• New Allergy Patient Intake Form English| Spanish
• New Allergy Patient Instructions English

If you are being seen for Immunotherapy (Allergy Shots), you may also complete the following forms:

• Immunotherapy (Allergy Shots) Consent Form English
• Immunotherapy (Allergy Shots) Serum Renewal Consent Form English